Automaticity Cognitive Behavioral Therapy for Incarcerated Young Men

The Automaticity Cognitive Behavioral Therapy (CBT) program is a cognitive behavioral therapy program for young incarcerated men. The program is implemented with young men who have been incarcerated in the Cook County Jail in Chicago. It uses cognitive behavioral therapy to help juvenile detainees more consciously slow down their thinking and reduce “automaticity” in their decision-making, and subsequently helps them think through their decision options more slowly and make safer, less risky behavior choices, instead of automatically using aggression, fear, confrontation, or force to solve problems. A year and a half after the intervention, re-admission to the juvenile detention facility dropped by four percentage points for those who had participated in the program.

DESCRIPTION OF PROGRAM

Target population: Low-income, male teens who are incarcerated and at high risk of committing more crime and/or dropping out of school

In the Automaticity Cognitive Behavioral Therapy for Incarcerated Young Men program, cognitive behavioral therapy (CBT) and tools like self-analysis, movies, and “behavior experiments” are used to teach adolescents to recognize and reduce problematic automatic behaviors and biased beliefs, such as hostile attribution bias. Afterschool programming is offered in group sessions, which follow a manualized curriculum, and are implemented by juvenile detention center staff. Youth participate in the programming for as long as they are detained before their case goes before a judge (typically three to four weeks). The goal is to help young people become more cognizant of the choices they are making in specific environments, and to understand that in some situations pausing to think will allow them to respond more safely, and in a manner that is less likely to result in violence or problems with the law.

Evaluated population: The evaluated population consisted of 2,693 young men who were incarcerated in the Cook County (Chicago) juvenile detention facility awaiting trial. The average age of participants was 16 years. The sample was mostly black (84 percent), 13 percent white, three percent Hispanic, and one percent reporting another race. Eighteen percent of the sample had been arrested for violent crime, 10 percent for property crime, eight percent for drug crimes, 35 percent for other crimes, and 30 percent for non-arrest violations. Additionally, many of the participants had a history of involvement with the juvenile justice system. The average total number of arrests that participants reported over their lifetimes was eight. This included, on average, two violent arrests, 1.5 property arrests, 1.3 drug arrests, 0.03 arrests related to motor vehicles, and 3.2 arrests for other reasons. On average, participants came from neighborhoods that were 69 percent black and 18percent Hispanic, and in which 73 percent of people reported at least a high school degree, 35 percent were below the poverty line, and 19 percent were unemployed.

Approach: Randomization occurred at the dorm level. Half of the dorm blocks were assigned to the program, and half were assigned to a status-quo control condition with free time instead of programming following school instruction for all detainees. Females were not included in the study, as there was only one dorm block and randomization was not feasible. Some of the young people could not be randomized, due to safety or behavioral concerns. There were no statistically significant differences between the groups at baseline. The key outcome measure of interest was whether or not the young man was re-admitted to the juvenile detention facility in the 18 months following the intervention. Attrition information was not reported.

Results: Two months after the program there was a decline in readmission rate of three percentage points in the intervention group. After 18 months, there was a four-percentage-point decrease (an additional one point was gained over time).